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6-9 hostasanddaylilies

Yesterday was unexpectedly amazing.

So, I have a little story to tell.

You remember my post about health insurance? That Don is now getting Medicare (as of June 1) and that our health insurance, purchased through the Affordable Care Act, had to be changed? The end result was that I had to change to an individual policy, which ended up being even more expensive than what we were paying for a ‘family’ policy – about $550/month just for me. Add to that the smaller amount that Don has to pay for Medicare Part B and we’re talking well over $600/month for healthcare.

Now I know many of you are faced with this challenge and some of you pay even more than this. I can only speak to our individual situation, which is that of freelancers who are basically on a fixed and very limited income and who have a hefty mortgage payment every month. When we move into a period like the present one, when neither of us has freelance work, our income is stretched to its limits.

So. On Tuesday I went to get the mail late in the day and saw an envelope from the Screen Actors Guild. (Don is a longtime member of 3 unions.) It was from their Health Care Plan with the words “Premium Notice.”  I was puzzled; we don’t have health care through the union, though we’ve had it in the past, because members have to earn a certain amount of money per year to qualify. Don wasn’t home from NYC yet, so I held onto it until he came in the door.

He opened it, and sure enough there was a bill for June, and then a list of upcoming quarterly payments. What? We hadn’t enrolled, could this have been sent to Don by mistake? Was it meant for some other union member? And Don was on Medicare, so surely he wasn’t qualified for this insurance anyway. We had a lot of questions.

We had to wait to call them until yesterday.

It turns out – and I couldn’t believe what I was hearing from Don’s end of the conversation – that Don has qualified for a special Senior level of health insurance through SAG and will be qualified for it for the rest of his life.

And so will I.

I got on the other line and every question we asked was answered in the affirmative. Can Don be on Medicare at the same time? Yes. Whatever Medicare doesn’t cover, we will. Will we have to pay a larger amount in order to have my wife on the policy? No. Since you were both covered in the past, we’ve already factored your wife in and the monthly payment of $120 is for both of you.

(At this point tears were rolling down my face.)

You have Blue Cross. (The deductible is one-tenth  of what I was paying on my individual policy.) You have discounted prescriptions. You have dental coverage. You have vision coverage. You have an unbelievably low out-of-pocket amount – around $1000.

From me: And will this continue into next year? Yes. You mean I won’t have to sign up for ACA in January? No, you won’t have to do that.

You mean we only have to pay $120.00 a month and that’s it? Yes.

Still crying from the enormous sense of relief I was experiencing, I thanked her over and over again and told her this was the answer to a prayer.

Don and I were in different rooms, each of us on the landline. When the call finished, we ran to each other and hugged, stunned and amazed by this gift that had come out of nowhere.

We’d never received a notice that this was going to happen. We just received the bill. My only quibble – and it’s a very, very small one – is that now I have to cancel my insurance and do my best to get a refund of part of my payment since I’ve only been covered for a total of 8 days. I’ve already cancelled it and tomorrow I’ll call to discuss the refund. But heck, I’m happy to jump through a couple of hoops – I’m thrilled.

Isn’t this wonderful?  Don didn’t know such a policy existed. It was just given to us. We didn’t have to do anything to qualify – it has something to do with ‘pension points,’ whatever that means. We don’t care what it means, we’re just so grateful that Don’s pension points are at a level that qualifies for this.

We are so thankful. An answer to a prayer that I didn’t even know I’d made.

6-8 redroses

We celebrated by buying some top soil for the memorial garden. That’s it. We’re being very, very frugal at the moment! We were so happy we didn’t even mind walking through the garden center in the rain! We didn’t have an umbrella and didn’t care.

It was such an emotional high that we sort of collapsed later in the day.

Isn’t that a great story?

Happy Thursday.

ClaudiaSignature140X93

 

Comments

  1. i am very happy for you and don!!! God answers prayers, even those we sometimes don’t ask.

  4. WOW, that is wonderful news. You have both worked hard and deserve this great policy.

  8. Claudia, I have tears in my eyes and chills up my arms! What an amazing story. I so understand the limited income and insurance. Before Medicare I did not have insurance for 4 years. What a blessing this is. Prayers answered. Happy Dance!!
    hugs,
    Linda

    • Happy Dance for sure, Linda. Happy Birthday, my friend! I’m going to get that package in the mail for you this week. I promise! Much love to you and yours.

      • Thank you for the birthday wishes. I think Mom and I will go out to eat and I may go shopping for some new clothes for myself. :) I did win an auction on Ebay this morning for a Roseville flower frog I fell in love with. Spent a bit more on it then I usually do but it’s very special and a birthday gift to me from me!

        • I firmly believe we should give ourselves birthday gifts. Congratulations! How many flower frogs do you have at this point?

          • I have six, seven with the new one of Roseville flower frogs and many others. I am taking photos to do a post. I also have 6 small Roseville vases/pots that fit in the cubbies. It is so addictive. Each piece is so pretty and I love the variety of patterns. The piece I bought today was my most expensive so far. I’ve been watching it for a long time and how appropriate that it ended on my birthday!

            • Perfect. Roseville is so beautiful! I’m itching to get some more, but I’ll have to wait a bit.

  11. WOW that is incredible. I’m just a couple years shy of retiring and I worry now about how I will pay for healthcare then. That is such a gift!

  15. Wow! What a gift! We know all to well the difficulty of making those huge insurance payments on a fixed income. I am thrilled for you! ;)

    • Thank you so much, Martha! The roses arrived yesterday and I’m going to plant them today. Photos soon! xoxo

  17. It is a wonderful “gift”, but remember that you EARNED it!! Unions DO have benefits. ?
    So happy for you both! Absolutely LOVE how you celebrated!!

  18. Fantastic news! You must be feeling such relief! I wouldn’t know what to do with myself. If your life were a musical, you would have burst into a song and dance after hanging up the telephones. Congratulations! Virtue has been rewarded (my father would say).

  19. Dear Claudia You know what that is? That’s “A little old fashion KARMA”.
    or some call it “A Blessing” it all comes from the same place! To people striving to live good, honorable, lives
    I’m so glad for you!.-Judy A-

  20. I read your blog faithfully every day and look forward to your posts and book reviews, but unfortunately do not have time to leave a comment very often – however, I have to with this post -HOORAY!!! I am so very, very happy for you and Don.

  21. Claudia, a big happy sigh of relief. Seldom do we get good news when it comes to health insurance. The saving are great, a bit of breathing room for you both, less to worry about. I do think I could have found a better way to celebrate than buying dirt! hahaha

  22. I’m so glad for you both. A wonderful surprise!

    I’m very glad for Scotland’s NHS which is not under the privatisation threat of the English healthcare system. There are some bills to pay for dental work and spectacles but they fall within my budget.

    It is such a relief when you are freelance and paid intermittently.

    • You are very lucky – and I wish we had the same universal health care here, Carol. Thanks so much!

  23. What a wonderful story!! Truth stranger than fiction, as they say! After what you two have been through recently, you certainly deserved this special blessing!!

  24. As wonderful and fun getting a new mini or Roseville pottery piece is, affordable health care insurance for life is probably the most profoundly vital “gifts” you can receive. I’m so happy that you and Don are covered for life (thank you, Don, for accumulating those all-important points!), and the premiums don’t break the budget. I know how careful both of you are with money, so I know you won’t go blow a wad of your revised budget. But, I heartily approve of the top soil purchase (!), and perhaps a few more treats for each of you ….

    • No, we don’t suddenly have a whole bunch of cash to blow, Wendy! And we had to pay a little extra that wasn’t in the budge to get started on the new policy, while waiting (hopefully) to get a refund on what I’ve already paid. It’s a little tight here. But soil? We can do that! Thanks, Wendy.

      • Claudia, I am so happy for this good insurance news for you and Don. I have a thought on how you may can defend your request for a refund. If the SAG policy had you covered for the same time period, you may can ask for and receive a total refund citing the double coverage. Worth a try!
        Susan

        • That’s what I’m trying to do. I have to get NY State of Health to back-date the policy and then, hopefully, MVP will refund.

  26. What a wonderful surprise for both of you. I can only imagine the amount of relief you both felt. There is so little to count on in this lifetime. Health care shouldn’t be one of them, but I am very
    happy that you have been blessed and given some financial relief and assurance of health coverage at a very reasonable price. Prayers are often answered in mysterious ways. Bless you both.

    • They are indeed, Ranee. I never expected this and neither did Don. We are feeling very blessed right about now.

  27. Claudia, I am ecstatic for you! What a gift and a blessing! We are in the same boat that you and Don were in. Kerry is retired and on Medicare. I don’t yet qualify for Medicare. I’m also self-employed, just as you and Don are. The medical insurance payments for me, and me alone, are over $700 a month. It’s absolutely crazy. I never thought I’d look forward to aging, but getting onto Medicare will sure take some of the sting out of it! Again, VERY happy for you and Don!

    • It IS crazy! And mine went up because I am now getting social security, which made our income go up and I was no longer eligible for a tax credit. (I don’t think Social Security, which, after all I’ve accumulated and paid for, should be counted as income, but that’s a discussion for another day). I never thought I’d be saying I was looking forward to Medicare, either! But I am!

  30. I work with patients who often use insurance and good stories like this are rare indeed. It couldn’t have happened to nicer people. I’m thrilled for you!

  31. Wow, that is so good! I am so happy for you and Don. These days happy stories are very rare.
    You deserve this small miracle.

  32. This is excellent testimony how God is always present in our lives. He sees what we need and provides it.’
    A few years ago I had some past due dental work done. The dentist told me that not many of my teeth were worth saving. I sat in the chair and balled. I couldn’t imagine living without ANY teeth. The dental assistant came in and said we needed to make appointments for extractions and for measurements of the dentures. I told her I didn’t have that kind of coverage. She said I did. Well, long story short like you when I got home I called my insurance company. I asked many many questions. I did have denture coverage!
    I do understand your feelings of being grateful. I am every single day.

    • I agree. I just have to learn to get out of the way and Let Go, Let God!

      That’s a great story, Trudy. We think we know, but there’s always more to be revealed, isn’t there?

  35. Yes, ma’am. It is indeed a VERY happy story, not to mention, well-deserved. I could actually feel your euphoria and am thrilled for you both!! PS – God bless the Screen Actors Guild too. In this age, as most labor unions seem to be losing a LOT of ground, this kind of thing should be made known and as much as possible. People need to know how much can be accomplished when we all pull TOGETHER … ?

    • Exactly. We are very pro-union here and support them. I also grew up in the Detroit area where all of my neighbors (it seemed) worked for the auto companies and had great unions and great benefits. I don’t understand why any worker wouldn’t want a union to represent them. The list of things that Actors Equity, SAG, and AFTRA have done for actors – including humane hours, child worker protection laws, overtime, is endless!

      • So true. Unions have often been the difference between night & day in many professions, and I would think particularly so in the performing arts. Of course, I always chuckle anytime someone mentions that the stalwart Head Republican of All Time, Ronald Reagan, was originally a Democrat. And actually the SAG President at one point. In the 50s, I think. LOL !! ?

  36. What an unexpected blessing in a rather difficult week for the two of you. I’m so happy that this “dropped from the sky” for you. Insurance is a frustrating thing for so many right now. My Hubby and I both met our “out of pocket” limit by the end of February this year for the first time ever. My pacemaker was making my heart do wonky things and Hubby had emergency surgery. He had never been in the hospital before. Having those huge out of pocket bills on top of the premiums at the beginning of the year just about did us in. Thank goodness we should have no medical bills for the rest of the year. Then we start over. Eee!
    Blessings,
    Betsy

    • I’m sure that financial stress didn’t help the stress you both were already feeling about surgery and a pacemaker. No one should have to worry about out-of-pocket costs at a time like that. Thank you, Betsy.

  37. Wow what a wonderful bill to get in the mail! Glad your lives will be a bit easier and with better health care coverage too!

  39. Having health care is such a worry in this country..I am so glad to hear that this burden has been lifted for you and Don…Two of the nicest people I’ve never met..lol…

  40. Divine intervention! I am so happy for you both, the burden of bills can be so overwhelming. What a difference it will make!

  41. “Lord, all my desire is before You; And my sighing is not hidden from You”
    Psalm 38:9
    Jesus said that God knows what we need before we ask , because He IS the God that sees ME!

    I am THRILLED to bits for you and Don, Claudia ; truly – THRILLED TO BITS!!! :D

  42. I so LOVED hearing your happy story! I think it’s karma. You and Don are good people. Good things SHOULD happen to you both! CONGRATS!

    The whole medical insurance thing is a major worry for me. I have some serious health problems. My husband insists he’s retiring in two years which will leave a year’s gap in health coverage…for me (he’ll already be on Medicare; I’m younger). I am only covered thru his employer’s insurance…so, with no employer, I’m left with nothing. My husband keeps talking about the Affordable Health Care thing coming to the rescue, so I’m going to print off part of what you wrote about that so that he can see just how expensive it is (I’ve heard horror stories about this from more than just you…actually, what I’ve learned from people even in my ‘everyday’ is that they’ve opted simply to have no medical insurance but this is no option for me whatsoever and I can’t believe what they’re risking when, in the age of one’s 50s and 60s, health problems can crop up out of nowhere [but they say they have no choice; they just don’t have the money]). This whole subject needles at the back of my mind, so I can certainly try to imagine what you’ve been going through by trying to figure out how to get along with paying such a large premium. My husband’s retirement income isn’t great, and to have to pay out that much money in insurance costs per month…for a year…when we also, like you, have a mortgage payment? I think he needs to work another year (easy for me to say; I’m not the one with the hard job!).

    In my ‘fantasy’ over the years (lack of knowledge), I just had never thought that anyone, at this stage of life, had to be so worried over these types of things. It’s ‘depressing’ to have to face ‘the golden years’ when they aren’t looking so golden. I watched my mom go through this all too recently. By the time she passed, she was broke. It took SO MUCH MONEY in the last five years of her life, to pay for her life…when it was enough (too much) just to be quite elderly and very sick. It’s when I get really incensed with the comment, “Money doesn’t buy happiness” – because what it DOES buy is stuff like health insurance, getting to the best doctor, being able to pay for caregivers to take care of you in your home when you need the help, and freedom from stress knowing that you’ve made your bills that month. It was horrendous that after being frugal their entire lives and actually saving a commendable amount of money for their old age, that my folks had to see the money running through their fingers as they aged and became victims of illness and disease. Reaching their 80s was such a milestone, but it was framed by uncertainty, worry and fear…over finances, on top of fading independence and feeling like crap due to medical issues. It isn’t the way it should be. But it’s reality for a lot of people. Rich folks have no clue about how it really is for the rest of us.

    Oh dear, I descended into Debbie Downer; sorry! Faith! Hope! Where He closes a door, somewhere else He opens a window. It is so uplifting to hear of your news; thank you for sharing your joy…truly, I’ll let it stay with me today! I can indeed ‘hear’ your relief in your words!

    • No, you’re right. These are real worries and so many people that have reached the time of life in which they think they can relax, suddenly find they can’t. My mom’s nursing home care required the hiring of a lawyer who specialized in Medicaid and my dad liquidating a certain amount of his savings and stocks in order to have only so much money on hand. It was ridiculous. Hiring the lawyer alone cost more than they could really afford. But my mom and dad were of the generation where someone worked at the same company for 40 years and had a great pension, etc. So they were comfortable in their retirement. We are artists, nomads, and paying a high mortgage to boot – like you, we bought our home later in life, so we’re doing the exact opposite of what so many do. Sigh.

      I know you worry about ACA. My experience is that you can find health coverage but whether you get a tax credit to offset the cost is dependent on your income and because Don and I were in our sixties, we automatically had to pay a higher premium because we were in the ‘risky’ age group. For young people, it’s an incredible help. For young families – probably the same. But for many, many Americans. especially those of us in our later years, it isn’t really affordable at all. Before ACA, I used to have a “Catastrophic” policy, which covered hospitalization only. But when ACA was implemented that was no longer an option. Sigh again.

      • Well, thanks again for sharing more of your story. It helps. (I don’t want to seem like ‘misery loves company’, though…I think I’m sounding pitiful…and, you know, Claudia, it’s like I said, we have to keep the faith. But I’ve learned a lot on your blog; again, it helps. Because of what readers and you said here, I’m now going to apply for Social Security earlier than I’d planned; I’ve looked into it, and y’all are right!)

        My situation is so similar to yours and Don’s; you have no idea…my husband has repeatedly been a freelancer (’tis the nature of the biz/beast, isn’t it, in the entertainment industry), and I personally had the misfortune of being between jobs when I experienced my first and completely-unexpected (major) health crisis; so it wasn’t like I could tap into an employer’s long-term disability plan or anything like that (I used to laugh, not in a haha-funny way, about all the money deducted from my pay, for benefits, over YEARS of working, none of which when younger I ever used…and, then, in the one period where I voluntarily and purposely took time away from work {just one precious year} after 25 years of nonstop employment ( NEVER a break), THAT had to happen {surgery which went ‘way wrong}; whereas I’d thought I’d planned it all out rather carefully, never dreaming something would happen to where I couldn’t really realistically work again, at least like in the jobs I’d had).

        And, yes, with the parents…sort of freelancers (self-employed for 40 years)…you know, we had no road map. Nobody in our realm of extended family had ever had to take care of elderly parents as adult children. None of my friends had either. I didn’t have anybody to turn to for early advice (who would have made me actually listen to reason). It was SUCH foreign territory for my parents, my husband and me. It’s not like there’s a manual on it although, of course, as skies cleared since their passing and it’s all over now, I’ve found many books about care of our elders and ‘what to do’ (I dunno; at the time, I don’t think I had the ability to concentrate on guide books, you know?!). We had no prep; my one parent went into a completely-changed scenario in a 24-hr nightmare. Your life is one way one day; and the next, it’s irrevocably altered forever…and I actually direct that comment almost more to me, than them. Impossible to describe, and I’m not the one who died, but I think as adult child/caretaker I suffered more destructible change although that, of course, sounds unbelievable, selfish and is an arguable point. But, on November 19 I was in my own house and living my life with my husband (not well myself), then November 20 came and I was thrust into living with them, trying to take care of all three of us, feeling the obligation, meeting the obligation, scared; drowning…it was not the right way to do it. I did have one discharge nurse at the hospital tell me that I didn’t know what I was getting into and that I wouldn’t be able to pull it off by keeping my parents at home. I tossed it off; I thought I was different. We were always people who figured it out. Private types, who didn’t go to the ‘outside’ for help.

        Anyway, everybody has their story. I do now know that within a very short time after my father’s death, we shoulda/woulda/coulda escorted Mother directly to a elder-care specialist/attorney to try to see how to hold on to some of the money, but it’s hard to go back and remember the mood at the time, for Mom and us, with it all mixed up in grief, trepidation; so much unknown. The takeaway, and I tell anyone this, is…early-on…get help; get professional advice on finances and from a social worker on the medical needs. Relying on the doctor wasn’t a big help. He actually gave us really wrong info which completely, not for the best, changed the course of things; doctors are probably between a rock and a hard place when we ask them to play God and give us a timeline. Having a intractable, terrified, recently-widowed and super-elderly & ill parent was also a hurdle because our hearts broke for her. We went into shield mode from Day One, wanting to protect her from so much hard change. You do what you do. Some of it’s good; some of it’s not.

        I appreciate your take on things, Claudia.

  43. Oh Claudia and Don,

    Thank you God for answered prayers! what an amazing gift ! I can only imagine the relief that you feel knowing that your medical insurance is totally covered and you never have to worry about it again…. what a burden lifted! I am so truly Happy for you!
    I too will receive my Medicare September lst of this year and will continue to be covered by the Insurance I have at my job also! I know that wonderful feeling of relief!

    • That is amazing. I didn’t know you could have both at the same time and I’m thrilled you can!

  44. That’s wonderful news, I am very happy for you both. I didn’t realise health insurance was so expensive in America, as a single woman top medical insurance here in Australia would cost me less than $200.00 a month. Have a lovely day, I hope you manage to get your refund.

    • I do, too. I expect I will, I just have to call them tomorrow. Jan, Health Care is extremely expensive here. It’s so hard for so many to afford health care.

  45. Don must be feeling like a million bucks today. He has stayed true to a profession he loves and has a gift for. Now you both find out he was building up this financial security in the form of health insurance from his lifetime of work. Pension points indeed! Very happy for you two.

    • I’m going to pass this along to Don, Kaye. Thank you for that lovely message!

  46. Yes indeed, a very happy story! Thank you for sharing with us…my entire week thus far has been filled with sad and bad news. I needed a happy story for once. I am happy for you and Don!

    • I’m sorry you’ve been having such a sad week, Melanie. I hope it gets better!

      Thank you!

  47. SO happy for you! You deserve this fantastic break! It definitely is an answer to prayer and, I like to say, “a major God-wink!” Please do something fun for the two of you to celebrate!

  48. This may have been said above, but this is proof that good things happen to GOOD people!

  49. I haven’t read any comments- but when I got to the end and I read that one line… ” an answer to a prayer I didn’t even know I’d made.’ That made me smile. He knows what we have need of before we ask!!! Isn’t that wonderful?

  50. Oh Claudia, I am so thrilled for you and Don!!! I have insurance(more like major medical) through the marketplace and HATE it. I can only imagine how relieved you are. How I love happy endings!

    • It’s so frustrating (insurance in or out of the marketplace) – the premiums are so high, the deductibles are outrageous. We are grateful.

  53. Little pot of gold at the end of the rainbow, and the rain brought forth flowers on top of it! :D Congrats!

  54. Well, you and Don deserve a break and a permanent one is even better! After what most people would consider a crap year with deaths of loved ones (furry and upright) you needed something – and it couldn’t have happened to more deserving people. You never know what is around the corner, do you?

  55. So very, very happy for you both. This will be a life changer and will help to ease
    some of your financial burden. Wonderful news for a wonderful couple.

  56. What a fabulous event! Insurance and taxes, the hardest $$$$ issues in retirement. Happy for you!

  57. So pleased about your good news!! I am going on Medicare next month. The last 23 months have been hard with three changes of insurance (was covered by my husband’s work until he went on Medicare 23 months ago). So, I can understand your relief and happiness! So wish our country could do better with all this – Obama has helped a great deal, but more must be done. Never mind the nightmare of having to do all the paperwork, worry and advocating for oneself. It must be really hard for some people to try and negotiate all this.

    • I know. I am grateful for ACA, but it needs improvement. For someone of my age, it’s not been ‘affordable’ and I hope that that is addressed in the future. We’ve changed insurance, as well. The first provider we had with ACA was a start-up and it just became too difficult for the company to continue, so we had to change to another. And then another. I’ve had major issues with NY State of Health (the NY version of ACA) and I will be so happy when I never have to deal with them again!

  58. That’s wonderful news!
    I have Blue Cross, and here in Texas it’s now going up 60%.

    Don’t know what I’ll do. (I’m still pretty livid over being FORCED to pay this every month. Money I don’t even have… and now they’re forcing me to pay even more. Feels like I’m living under a dictatorship).

    • Well, of course, you don’t have to pay. If you choose not to pay, at least under ACA, you just pay a penalty on your income tax, which many people find is much less expensive than paying a premium.

  59. Part of it is the principle of the whole thing. No one should be forced to pay, and if they can’t afford it will have to pay a penalty. It simply isn’t right, and the insurance I do have is not worth what I pay for it. I had to go to the doc recently – (haven’t been to one in years) – and let me tell you… I’m not getting my money’s worth and it took hours of phone calls for me to even find a doctor that would accept me. Finally, I found one that was 2 hours away.

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